Addressing the health of a marginalized population in the U.S.: impact and policy implications for community health workers

ABSTRACT

The relationship between marginalization and health is clear, those in marginalized communities suffer poorer and worse health outcomes than those who are not. Addressing health determinants that affect vulnerable communities is sometimes best done when the influence of trusted and respected people providing outreach, assessments and intervention is present. The purpose of this article is to share the process of effectively working with community health workers (CHWs) in a marginalized community under the framework of community based participatory research (CBPR). This policy brief will discuss an intervention where CHWs participated in a community health assessment (CHA), the impact of the CHA, lessons learned and policy implications on the use of CHWs as research partners [or co-researchers] when working in a marginalized community.

RESUMEN

La relación entre marginación y salud es clara, quienes viven en comunidades marginadas sufren de un índice de salud más pobre. En ocasiones, es mejor abordar los determinantes de la salud que afectan a las comunidades vulnerables cuando existe la influencia de personas confiables y respetadas que brindan los programas de alcance comunitario, evaluación, e intervención. El propósito de este artículo es compartir el proceso de trabajar eficazmente con Promotores de Salud en una comunidad marginada en el marco de la investigación participativa basada en la comunidad. Este resumen de políticas informara acerca de una intervención en la que los Promotores de Salud participaron en una evaluación de salud comunitaria, el impacto de la evaluación de salud comunitaria, lecciones aprendidas, y las implicaciones de políticas en el uso de Promotores de Salud como [co-investigadores] cuando trabajan en una comunidad marginada.

KEYWORDS:

• Community health workers
• marginalized
• community based participatory research
• community health assessment

PALABRAS CLAVE:

• Promotores de salud
• marginado
• investigación participativa basada en la comunidad
• evaluación de salud comunitaria

Acknowledgements

The authors would like to thank the community health workers who made this project possible, the Wellness committee for their support and guidance and the Desert Highland Gateway Community.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by Loma Linda University Institute for Community Partnerships, Desert Healthcare District and Foundation, and Loma Linda University School of Public Health.

Notes on contributors

Nipher Malika

Nipher Malika, is a social epidemiologist with a background in health disparities and community based participatory research having tackled diverse topics such as obesity, incarceration, education and at-risk populations. Currently pursuing her PhD in social policy, she aims to further engage questions of economic inequality immigration, poverty, and political inequalities.

Kristen Arthur

Kristen Arthur, is a health disparities epidemiologist whose primary research has focused on the social-cultural contexts of medicine and health with the goal to improve research translatability. Some of her previously published work includes complementary and alternative medicine use, and she’s worked in public health practice for local (minority, recidivism, cancer) and international (rural, HIV/TB, adolescent) vulnerable population groups.

Juan Carlos Belliard

Juan Carlos Belliard, is a community-based participatory researcher with a focus on community resiliency. His passion for teaching and health disparities allows him to influence young minds about reducing the inequities in our world.